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External quality assurance in Malaysia

Nawawi H, Lim HH, Zakiah I

Southeast Asian J. Trop. Med. Public Health, 1999;30 Suppl 3:39-45.
PMID: 10926257

An activity supportive of the MOH QA Programme, the National EQAS for clinical chemistry monitors for analytical performance in core routine biochemical testing by the pathology laboratories, with unsatisfactory performance scores serving to alert against deficiencies or problems and the scores in subsequent challenges providing the feedback of effectiveness of remedial actions taken. While unacceptable individual analyte performance score (variance index score, VIS) indicated problems in instruments, reagent and calibrators, or the use of inherently poorer methods, repeated occurrence of unsatisfactory OMRVIS was traceable to generally poor laboratory management of usually inadequately-equipment small laboratories. The outcome has been one of slow but gradual improvement in the overall performance of participating laboratories, with a move towards methods upgrading and standardization to achieve greater concordance of results. Presently, the programme is limited to 61 government and 4 private hospital laboratories in the country for 12 commonly assayed clinical biochemistry analytes. It is hoped that the NEQAS could be extended to the other private laboratories and that of academic institutions. However, this is dependent to a large extent on the manpower and financial support obtainable by the organizing body of the programme in the future. Belk and Sunderman, 1947 demonstrated that laboratories participating in an quality assessment scheme could rapidly and dramatically improve their analytical performance. In some countries, participation has become mandatory, and acceptable performance is a requirement in laboratory accreditation. The need and value of the NEQAP is, therefore, evident. While there may be limitations in the national programme. efforts are being made at improving the programme within the means and resources of the organising body. The goals of the NEQAP are not just to monitor performance but also to educate. On this, matters related to and supportive of these goals have also been pursued. The annual workshop/forum on quality controls had allowed exchange of information between representatives of participating laboratories and the organising body. Recently in the 1997 MOH Quality Improvement evaluation, Quality Control has been evaluated together with the other 17 such activities. The study on knowledge, attitude and practice has provided the necessary feedback and will be used for future planning in making efforts at increasing the effectiveness and benefits of the all QC activities including this NEQAP for clinical chemistry. In addition, there is a need to look into areas such as selection of methods and test systems, and improvement of continuing education, training as well as research in quality improvement as suggested by the Quality Improvement evaluation.

Matched MeSH terms: Peer Review/methods*
Personalised learning in higher education for health sciences: a scoping review protocol

Ali M, Wahab IBA, Huri HZ, Yusoff MS

Syst Rev, 2024 Apr 02;13(1):99.
PMID: 38566190 DOI: 10.1186/s13643-024-02478-4

BACKGROUND: Personalised learning, an educational approach that tailors teaching and learning to individual needs and preferences, has gained attention in recent years, particularly in higher education. Advances in educational technology have facilitated the implementation of personalised learning in various contexts. Despite its potential benefits, the literature on personalised learning in health sciences higher education remains scattered and heterogeneous. This scoping review aims to identify and map the current literature on personalised learning in health sciences higher education and its definition, implementation strategies, benefits, and limitations.
METHODS: A comprehensive search of electronic databases, PubMed, Scopus, Google Scholar, Educational Research Complete, and Journal Storage (JSTOR), will be conducted to identify relevant articles. The search will be limited to articles published in the English language between 2000 and 2023. The search strategy will be designed and adapted for each database using a combination of keywords and subject headings related to personalised learning and health sciences higher education. Eligibility criteria will be applied to screen and select articles. Data extraction and quality assessment will be performed, and thematic synthesis will be used to analyse the extracted data.
DISCUSSION: The results of the scoping review will present a comprehensive and coherent overview of the literature on personalised learning in health sciences higher education. Key themes and topics related to personalised learning, its definitions, models, implementation strategies, benefits, and limitations, will be identified. The geographical and temporal distribution of research on personalised learning in health sciences higher education will also be described. This scoping review will provide a structured synthesis of the available evidence on personalised learning in health sciences higher education, highlighting potential gaps and areas for future research. The findings will contribute to ongoing scholarly and policy debates on personalised learning in higher education, informing the development of best practices, guidelines, and future research agendas.

Matched MeSH terms: Review Literature as Topic
Fulltext The h-index in Elsevier’s Scopus as an indicator of research achievement for young Malaysian scientists

Yap, C.K.

Pertanika Journal of Science & Technology, 2012;20(2):197-203.
MyJurnal

If we were given a questionnaire of “How do we measure a researcher as a true scientist? with optional answers like (a) Having a good number of publications, (b) having attending numerous conferences, (c) with a high popularity as always appeared in mass media, and (d) good international networking and good public relations. Options (c) and (d) always come later after option (a) has been achieved, while option (b) can be simply achieved or abstract be accepted for presentation in any conference. Hitherto, publishing in any peer-reviewed journals carry a certain quality since they are highly subjected to peer review evaluation before the paper can be accepted for publication in a journal. Needless to say, those constructive comments given by the reviewers are very crucial in shaping our scientific understanding in our subject area rather than rejection experience (Yap, 2009). Having said so, option (a) will definitely be the best answer. The fact is that option (a) should not be argued whatsoever as the best answer [since publications speaks louder than anything else] and options (a), (b) and (c) are supplementary criteria to option (a) but they are not as vital as option (a). When we are asked ‘What is your scientific research performance or research output?’, the answer could always be ‘Having a good number of publications.’ Then, the next question forwarded is that ‘What is the quality and impact of your published papers to the scientific community?’ Of course, good and high impact factor journals always accept papers with high novelty in the subject area. Therefore, papers published in good journals are always highly cited and subsequently resulting in high impact (or citations) of the research done to the scientific community. However, the last question is sometimes very subjective and difficult to answer until h-index is introduced and discussed among the researchers. This paper aimed to discuss the h-index based on Elsevier’s Scopus database as an indicator of research achievement for young Malaysian scientists.

Matched MeSH terms: Peer Review
Fulltext A review of maternal mortality in Malaysia

Yadav H

International e-Journal of Science, Medicine & Education, 2012;6(10):0-0.
MyJurnal

There has been a significant decline in maternal mortality from 540 per 100,000 live births
in I957 to 28 per 100,000 in 2010. This decline is due to several factors. Firstly the introduction of the rural health infrastructure which is mainly constructing health centres and midwife clinics for the rural population. This provided the accessibility and availability of primary health care and specially, antenatal care for the women. This also helped to increase the antenatal coverage for the women to 98% in 2010 and it increased the average number of antenatal visits per women from6 in 1980 to 12 visits in 2010 for pregnant women. Along with the introduction of health centres, another main feature was the introduction of specific programmes to address the needs of the women and children. In the 1950s the introduction of Maternal and Child Health (MCH) programme was an important
step. Later in the late 1970s there was the introduction of the High Risk Approach in MCH care and Safe Motherhood in the 1980s. In 1990, an important step was the introduction of the Confidential Enquiry into Maternal Deaths (CEMD). Another significant factor in the reduction is the identification of high risk mothers and this is being done by the introduction of the colour coding system in the health centres. Other factors include the increase in the number of safe deliveries by skilled personnel and the reduction in the number of deliveries by the Traditional Birth Attendants (TBAs). The reduction in fertility rate from 6.3 in 1960 to 3.3 in 2010 has been another important factor. To achieve the 2015 Millennium Development Goals (MDG) to further reduce maternal deaths by 50%, more needs to be done especially to identify maternal deaths that are missed by omission or misclassification and also to capture the late maternal deaths.

Matched MeSH terms: Review
Fulltext Qualitative research methods in family medicine: what and why?

Wong LP

Malays Fam Physician, 2008;3(1):70.
PMID: 25606118
Matched MeSH terms: Review
Reflections on a decade of research by ASEAN dental faculties: analysis of publications from ISI-WOS databases from 2000 to 2009

Sirisinha S, Koontongkaew S, Phantumvanit P, Wittayawuttikul R

J Investig Clin Dent, 2011 May;2(2):72-80.
PMID: 25426599 DOI: 10.1111/j.2041-1626.2011.00048.x

This communication analyzed research publications in dentistry in the Institute of Scientific Information Web of Science databases of 10 dental faculties in the Association of South-East Asian Nations (ASEAN) from 2000 to 2009. The term used for the "all-document types" search was "Faculty of Dentistry/College of Dentistry." Abstracts presented at regional meetings were also included in the analysis. The Times Higher Education System QS World University Rankings showed that universities in the region fare poorly in world university rankings. Only the National University of Singapore and Nanyang Technological University appeared in the top 100 in 2009; 19 universities in the region, including Indonesia, Malaysia, the Philippines, Singapore, and Thailand, appeared in the top 500. Data from the databases showed that research publications by dental institutes in the region fall short of their Asian counterparts. Singapore and Thailand are the most active in dental research of the ASEAN countries.

Matched MeSH terms: Peer Review, Research
Fulltext Responding to extremes: managing urban water scarcity in the late nineteenth-century Straits Settlements

Williamson F

Water Hist, 2020 Oct 29.
PMID: 33144897 DOI: 10.1007/s12685-020-00260-6

In 1877, the major towns of the Straits Settlements-Singapore, George Town, Penang Island and Malacca-suffered a drought of exceptional magnitude. The drought's natural instigator was the El Niño phase of the El Niño Southern Oscillation, a climatic phenomenon then not understood by contemporary observers. The 1877 event has been explored in some depth for countries including India, China and Australia. Its impact on Southeast Asia however is less well-known and the story of how the event unfolded in Singapore and Malaysia has not been told. This paper explores how the contemporary British government responded to the drought, arguing that its impact on hydraulic management was at best minimal yet, it did have impact on other areas, such as forest reservation with the hope of preserving future rainfall. It also highlights how, in contrast to studies on urban water plans in other British Asian colonies, the colonial authorities in the Straits Settlements had a far less coherent and meaningful relationship with water in their town planning schemes. As this paper is part of a special issue, Water History in the time of COVID-19, it has undergone modified peer review.

Matched MeSH terms: Peer Review
Fulltext Barriers And Challenges Of Multidisciplinary Teams In Oncology Management: A Scoping Review Protocol

Law NLW, Hong LW, Tan SSN, Foo CJ, Lee D, Voon PJ

BMJ Open, 2024 Feb 10;14(2):e079559.
PMID: 38341218 DOI: 10.1136/bmjopen-2023-079559

INTRODUCTION: Multidisciplinary teams (MDTs) are integral to oncology management, involving specialised healthcare professionals who collaborate to develop individualised treatment plans for patients. However, as cancer care grows more complex, MDTs must continually adapt to better address patient needs. This scoping review will explore barriers and challenges MDTs have encountered in the past decade; and propose strategies for optimising their utilisation to overcome these obstacles and improve patient care.
METHODS AND ANALYSIS: The scoping review will follow Arksey and O'Malley's framework and begin with a literature search using keywords in electronic databases such as PubMed/MEDLINE, Scopus and PsychINFO, covering the period from January 2013 to December 2022 and limited to English language publications. Four independent reviewers will screen titles and abstracts based on predefined inclusion criteria, followed by full-text review of selected titles. Relevant references cited in the publications will also be examined. A Preferred Reporting Items for Systematic reviews and Meta-Analyses flow diagram will be utilised to illustrate the methodology. Data from selected publications will be extracted, analysed, and categorised for further analysis.
ETHICS AND DISSEMINATION: The results of the scoping review will provide a comprehensive overview of the barriers and challenges encountered by oncology MDTs over the past decade. These findings will contribute to the existing literature and provide insights into areas that require improvement in the functioning of MDTs in oncology management. The results will be disseminated through publication in a scientific journal, which will help to share the findings with the wider healthcare community and facilitate further research and discussion in this field.
TRIAL REGISTRATION DETAILS: The protocol for this scoping review is registered with Open Science Framework, available at DOI 10.17605/OSF.IO/R3Y8U.

Matched MeSH terms: Review Literature as Topic
An audit of fresh frozen plasma usage in a tertiary referral centre in a developing country

Prathiba R, Jayaranee S, Ramesh JC, Lopez CG, Vasanthi N

Malays J Pathol, 2001 Jun;23(1):41-6.
PMID: 16329547

This paper evaluates the practice of fresh frozen plasma (FFP) transfusion at the University Hospital, Kuala Lumpur, and analyses its usage by the various clinical departments. The aim of this study is to identify where it is inappropriately used and the clinical indications in which such misuse is common. A retrospective analysis of the blood bank request forms and work sheets during a 6-month period between January 1998 and June 1998 formed the basis of this study. Overall, 40% of 2665 units transfused were considered appropriate. However, out of the 931 episodes of FFP transfusions only 31% were for appropriate indications. The average FFP requirement when used for appropriate indication was about 4 units per episode, whereas for inappropriate indication it was 2.5 units per episode. Inappropriate use in terms of the number of units was highest by the surgical services (68%) and Orthopaedics (64%), while the Department of Paediatrics had the lowest incidence of inappropriate use (40%). When Paediatrics was used as the benchmark, the incidence of inappropriate use by other departments was significantly higher (p < 0.01). As for FFP usage in common clinical indications, there was a high incidence of inappropriate use in burns (82%), perioperative period (73%), cardiac surgery (68%), massive bleeding (62%) and trauma (60%). The findings in this study, specifically the use of FFP for volume support in trauma, massive bleeding and burns, routine requests without identified indication in cardiac bypass surgery, and prophylactic use in the perioperative period can be the basis for recommendations to minimize the inappropriate use of FFP in the future.

Matched MeSH terms: Utilization Review*
Fulltext Meal replacement in dietary management of type-2 diabetes mellitus: a scoping review protocol

Chen LL, Mat Ludin AF, Shahar S, Manaf ZA, Tohit NM

Syst Rev, 2020 Nov 23;9(1):265.
PMID: 33228765 DOI: 10.1186/s13643-020-01517-0

BACKGROUND: The prevalence of type-2 diabetes mellitus (T2DM) has been increasing globally. Without proper management, T2DM can develop into serious complications and even death. Diet modification is one of the most effective tools in managing T2DM at the early stage, but it requires knowledge and compliance from the patients. Thus, meal replacement (MR) has gained its popularity as a tool for diet modification to improve glycemic control and also reducing weight in T2DM patients. There are several existing meal replacement studies but not much is known on the general scope and effect of these existing MRs. Hence, this review is aimed to provide an overview of the existing evidences regarding the application of meal replacement on T2DM patients and identify the gaps or limitations in the studies.
METHODOLOGY: The scoping review will be carried out in six stages: (1) identifying the research question, (2) identifying relevant studies through electronic databases (i.e., PubMed, Scopus, Cochrane Reviews, Google Scholar, EBSCOHOST, Science Direct) and also gray literature, and (3) selection of studies to be included based on inclusion criteria. Search and initial screening of studies to be included will be conducted by two independent reviewers. Discrepancies will then be solved through discussion with other reviewers; (4) charting and categorizing extracted data in a pretested data extraction form; (5) collating, summarizing, and reporting the results; and lastly, (6) conducting consultation with stakeholders and experts in diabetes.
DISCUSSION: This scoping review protocol is aimed to provide a framework enabling us to map and summarize the findings from existing studies involving meal replacement. It will help researchers to identify the research gap and provide recommendations for future meal replacement studies. The results from this scoping review will be useful to various stakeholders in healthcare. It is also part of a research project in which the information obtained will be utilized in a clinical trial of a developed meal replacement plan. Dissemination of knowledge will also be done through presentations at related scientific conferences.

Matched MeSH terms: Review Literature as Topic
A six-year review of 35 cases of eclampsia at General Hospital Seremban

Tharmaseelan NKS

Family Physician, 1990;2:34-37.

Matched MeSH terms: Review
Ectopic pregnancy: a three-year review at General Hospital Seremban

Tharmaseelan NKS

Family Physician, 1991;3:22-24.

Matched MeSH terms: Review
Fulltext Nutrition and the Malaysian Healthy Lifestyle Programme: challenges in implementation

Suleiman AB, Tee ES

Asia Pac J Clin Nutr, 1998 Dec;7(3/4):230-7.
PMID: 24393676

There are significant differences in the food consumption patterns of countries. In the lower income countries, most of the energy intake is derived from cereals and starchy roots. On the other hand, the intake of these carbohydrate foods is much lower in the economically developed countries and more of the energy is derived from added fats, alcohol, meat, dairy products and sweeteners. The contribution of energy from various food groups has changed markedly over the past three decades. With increasing national wealth there is a general tendency for the consumption of cereal foods to decline, whereas the consumption of added fats, alcohol, meat and dairy products has increased over the years. Similar changes have also been observed for Malaysia. These dietary alterations, as well as other lifestyle changes, have brought about a new nutrition scenario in many developing countries. These countries are now faced with the twin problems of malnutrition, that is, undernutrition among some segments of the population and diet-related chronic diseases in other groups; for example, obesity, hypertension, coronary heart disease, diabetes and various cancers. In Malaysia, deaths due to diseases of the circulatory system and neoplasms have been on the rise since the 1960s. The former has been the most important cause of death in the country for more than 15 years, with cancer ranking third for almost 10 years. Epidemiological data collected from different community groups showed increased prevalences of various risk factors amongst Malaysians. In view of the changed nutrition scenario in the country, intervention programmes have been reviewed accordingly. The Healthy Lifestyle (HLS) Programme was launched in 1991 as a comprehensive, long-term approach to combating the emerging diet-related chronic diseases. For six consecutive years one thematic campaign per year was carried out; namely, coronary heart disease (1991), sexually transmitted diseases (1992), food safety (1993), childhood diseases (1994), cancers (1995) and diabetes mellitus (1996). To further strengthen health promotion among the community, another series of activities to be carried out under the second phase of the HLS programme from 1997 to 2002 was launched within the framework of the National Plan of Action on Nutrition (NPAN) for Malaysia. In view of the importance of diet and nutrition in the causation and prevention of chronic diseases, the theme for the first year of this phase was Healthy Eating. It is clear that nutrition education for the community in order to inculcate a culture of healthy eating is the long-term solution. A series of guidelines have been prepared for dissemination to the public via a variety of media and approaches, and with the collaboration of various government and non-governmental organisations. The implementation of the programme is, however, a challenge to health and nutrition workers. There is a need to examine the strategies for nutrition education to ensure more effective dissemination of information. The challenge is to determine how best to promote healthy eating within the present scenerio of rapid urbanisation, 'western' dietary pattern influence, a whole barrage of convenience and 'health' foods, and nutrition misinformation. We would like to share our experiences in the approaches taken and our concerns with other countries in the region given that various opportunities exist for collaboration.

Matched MeSH terms: Review
Fulltext Nutrition of Malaysians: where are we heading ?

Tee ES

Malays J Nutr, 1999 Dec;5(1):87-109.
PMID: 22692361 MyJurnal

Rapid and marked socioeconomic advancements in Malaysia for the past two decades have brought about significant changes in the lifestyles of communities. These include significant changes in the dietary patterns of Malaysians, eg the increase in consumption of fats and oils and refined carbohydrates and a decreased intake of complex carbohydrates. This resulted in a decline in the proportion of energy from carbohydrates, while an increase in the percentage contribution of fat has been observed. Changes in meal patterns are also evident: more families eat out, busy executives skip meals, the younger generation miss breakfasts and rely too much on fast foods. Many Malaysians have the mistaken belief that the taking of vitamin and mineral supplements can make up for the lack of these nutrients in their daily diets. In addition, communities have become generally more sedentary. All these changes have brought about undesirable effects with significant proportions of the affluent segments of the population being afflicted with various non-communicable diseases associated with overnutrition, namely obesity, hypertension, coronary heart disease and cancers. Nutrition activities and programmes are now being directed to tackle this increasing trend, whilst still attempting to eliminate the undernutrition problems. The ultimate strategy towards achieving a healthy nation is the promotion of a healthy lifestyle, including inculcating a culture of healthy eating. Comprehensive long term programmes, including a series of Healthy Lifestyle (HLS) Programmes have been carried out by the government. Launched in 1991 for six consecutive years, the first phase of the Programme comprised one thematic campaign each year, commencing with coronary heart disease and ending with diabetes mellitus. To further strengthen this long-term strategy, another series of activities to be carried out under the second phase of the HLS programme from 1997 to 2002 was launched within the framework of the National Plan of Action on Nutrition (NPAN) for Malaysia. The implementation of these programmes is, however, a challenge to health and nutrition workers. There is a need to examine the strategies for nutrition education to ensure more effective dissemination of information. The challenge is to determine how best to promote healthy eating within the present scenerio of rapid urbanisation, "western" dietary pattern influence, a whole barrage of convenience and "health" foods and nutrition misinformation. Malaysia continues to march ahead with its development plans to elevate the nation and its people to an even higher level of socio-economic status. The crucial question is: are we able to arrest the increase in these diet-related chronic diseases ? Or are we heading towards further deterioration in dietary pattern and increase in these diseases ? It will be a difficult and challenging journey ahead, requiring the concerted effort of all in the country. It is hoped that through this conference of sharing experiences with other Asian countries, a better understanding and improved strategies could be arrived at.

Matched MeSH terms: Review
Choice of drugs in pregnancy - a critical review

Tan FEH

Family Practitioner, 1975;2:48-51.

Matched MeSH terms: Review
Addiction to sugar and its link to health morbidity: a primer for newer primary care and public health initiatives in Malaysia

Swarna Nantha Y

J Prim Care Community Health, 2014 Oct;5(4):263-70.
PMID: 24879656 DOI: 10.1177/2150131914536988

Objectives: The average consumption of sugar in the Malaysian population has reached an alarming rate, exceeding the benchmark recommended by experts. This article argues the need of a paradigm shift in the management of sugar consumption in the country through evidence derived from addiction research.
Methods: “Food addiction” could lead to high levels of sugar consumption. This probable link could accelerate the development of diabetes and obesity in the community. A total of 94 reports and studies that describe the importance of addiction theory–based interventions were found through a search on PubMed, Google Scholar, and Academic Search Complete.
Results: Research in the field of addiction medicine has revealed the addictive potential of high levels of sugar intake. Preexisting health promotion strategies could benefit from the integration of the concept of sugar addiction. A targeted intervention could yield more positive results in health outcomes within the country.
Conclusion: Current literature seems to support food environment changes, targeted health policies, and special consultation skills as cost-effective remedies to curb the rise of sugar-related health morbidities.
Keywords. sugar addiction, food environment, health promotion, non communicable diseases, dietary habits, health policies

Matched MeSH terms: Review
Fulltext Health research in Malaysia: overview and future directions

Jegathesan M, Suleiman AB

Southeast Asian J. Trop. Med. Public Health, 1992 Dec;23(4):570-1.
PMID: 1298063
Matched MeSH terms: Review
Fulltext The evidence from clinical trials on Gout medicines effect on COVID-19: A protocol for systematic review and meta-analysis

Bitar AN, Sulaiman SAS

Nurs Open, 2023 Apr;10(4):2684-2688.
PMID: 36443281 DOI: 10.1002/nop2.1501

AIM: To evaluate the available evidence from clinical trials on the efficacy of gout medicines against COVID-19.
DESIGN: Systematic review and Meta-analysis.
METHODS: We are systematically searching five databases [PubMed, Embase, CT.gov, ICTRP, CINAHL (EBSCO)]. We are following the PRISMA statement and the EPOC guidelines. The meta-analysis will be conducted using Revman-5.4.1 from Cochrane collaboration, UK. This review's protocol was also registered in PROSPERO, University of York, UK (CRD42022299718).
RESULTS: In this meta-analysis, we plan to give a conclusive overview of the available evidence on the efficacy of the medications used to manage gout in reducing COVID-19 mortality, ICU admission, ventilation rate and hospitalization duration. If the results were positive, these drugs would greatly add to the scarce treatment options against COVID-19. Furthermore, these drugs might provide an excellent alternative to inconvenient and expensive drugs. Additionally, most of these drugs have a well-established safety profile for use during nursing, making them a much safer option for nursing mothers with COVID-19.

Matched MeSH terms: Review Literature as Topic
Fulltext Drug-related problems in patients with benign prostatic hyperplasia: a cross sectional retrospective study

Zaman Huri H, Hui Xin C, Sulaiman CZ

PLoS One, 2014;9(1):e86215.
PMID: 24475089 DOI: 10.1371/journal.pone.0086215

Benign Prostatic Hyperplasia (BPH) patients are at risk of acquiring drug-related problems (DRPs), as it is present in the majority of aging men. To date, DRPs among BPH patients have not been well studied. We conducted this retrospective study in a tertiary hospital in Malaysia from January 2009 to June 2012 with the aim of identifying the factors associated with DRPs among BPH patients. The Pharmaceutical Care Network Europe Classification Version (PCNE) 5.01 was used as a tool to classify DRPs. We enrolled 203 patients from 259 hospital admissions. A total of 390 DRPs were found and there was an average of 1.5±1.3 problems per hospitalization. 76.1% of hospital admissions included at least one DRP. The most common DRP categories encountered were drug choice problems (45.9%), drug interactions (24.9%), and dosing problems (13.3%). Factors such as advanced age (p = 0.005), a hospital stay of more than 6 days (p = 0.001), polydrug treatments (p<0.001), multiple comorbidities (p<0.001), and comorbid cardiovascular disease (p = 0.011), diabetes mellitus(p = 0.001), hypertension (p<0.001) and renal impairment (p = 0.011) were significantly associated with the occurrence of DRPs. These data indicated that the prevalence of DRPs is high among BPH patients. The identification of different subtypes of DRPs and the factors associated with DRPs may facilitate risk reduction for BPH patients.

Matched MeSH terms: Drug Utilization Review/statistics & numerical data*
Fulltext Multilevel interventions as climate change adaptation response to protect maternal and child health: a scoping review protocol

Lokmic-Tomkins Z, Bhandari D, Watterson J, Pollock WE, Cochrane L, Robinson E, et al.

BMJ Open, 2023 Jul 27;13(7):e073960.
PMID: 37500279 DOI: 10.1136/bmjopen-2023-073960

INTRODUCTION: Growing evidence suggests that climate change-related extreme weather events adversely impact maternal and child health (MCH) outcomes, which requires effective, sustainable and culturally appropriate interventions at individual, community and policy levels to minimise these impacts. This scoping review proposes to map the evidence available on the type, characteristics and outcomes of multilevel interventions implemented as adaptational strategies to protect MCH from the possible adverse effects of climate change.
METHODS: The following databases will be searched: Embase, MEDLINE, Emcare, EPPI-Centre database of health promotion research (BiblioMap) EPPI-Centre Database for promoting Health Effectiveness Reviews (DoPHER), Global Health, CINAHL, Joanna Briggs Institute EBP Database, Maternity and Infant Care Database, Education Resource Information Center, PsycINFO, Scopus, Web of Science and Global Index Medicus, which indexes Latin America and the Caribbean, Index Medicus for the South-East Asia Region, African Index Medicus, Western Pacific Region Index Medicus. Cochrane Central Register of Controlled Trials, WHO International Clinical Trials Registry Platform, ClinicalTrials.gov, conference proceedings, thesis and dissertations, policy and guidelines and their reference lists will also be searched. Two reviewers will independently screen titles and abstracts and full text based on predefined eligibility criteria. The Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews using the Population, Concept and Context framework and the Template for Intervention Description and Replication checklist will be used to structure and report the findings.
ETHICS AND DISSEMINATION: Ethics permission to conduct the scoping review is not required as the information collected is publicly available through databases. Findings will be disseminated through a peer-reviewed publication and conference presentations.

Matched MeSH terms: Review Literature as Topic

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